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Vaccinating For Flu During Pregnancy....

Flu in Pregnancy May Quadruple Child's Risk for Bipolar Disorder

May 14, 2013 — Pregnant mothers' exposure to the flu was associated with a nearly fourfold increased risk that their child would develop bipolar disorder in adulthood, in a study funded by the National Institutes of Health. The findings add to mounting evidence of possible shared underlying causes and illness processes with schizophrenia, which some studies have also linked to prenatal exposure to influenza.

"Prospective mothers should take common sense preventive measures, such as getting flu shots prior to and in the early stages of pregnancy and avoiding contact with people who are symptomatic," said Alan Brown, M.D., M.P.H, of Columbia University and New York State Psychiatric Institute, a grantee of the NIH's National Institute of Mental Health (NIMH). "In spite of public health recommendations, only a relatively small fraction of such women get immunized. The weight of evidence now suggests that benefits of the vaccine likely outweigh any possible risk to the mother or newborn."

Brown and colleagues reported their findings online May 8, 2013 in JAMA Psychiatry.

Although there have been hints of a maternal influenza/bipolar disorder connection, the new study is the first to prospectively follow families in the same HMO, using physician-based diagnoses and structured standardized psychiatric measures. Access to unique Kaiser-Permanente, county and Child Health and Development Study databases made it possible to include more cases with detailed maternal flu exposure information than in previous studies.

Among nearly a third of all children born in a northern California county during 1959-1966, researchers followed, 92 who developed bipolar disorder, comparing rates of maternal flu diagnoses during pregnancy with 722 matched controls.

The nearly fourfold increased risk implicated influenza infection at any time during pregnancy, but there was evidence suggesting slightly higher risk if the flu occurred during the second or third trimesters. Moreover, the researchers linked flu exposure to a nearly sixfold increase in a subtype of bipolar disorder with psychotic features.

A previous study, by Brown and colleagues, in a related northern California sample, found a threefold increased risk for schizophrenia associated with maternal influenza during the first half of pregnancy. Autism has similarly been linked to first trimester maternal viral infections and to possibly related increases in inflammatory molecules.

"Future research might investigate whether this same environmental risk factor might give rise to different disorders, depending on how the timing of the prenatal insult affects the developing fetal brain," suggested Brown.

Bipolar disorder shares with schizophrenia a number of other suspected causes and illness features, the researchers note. For example, both share onset of symptoms in early adulthood, susceptibility genes, run in the same families, affect nearly one percent of the population, show psychotic behaviors and respond to antipsychotic medications.

Increasing evidence of such overlap between traditional diagnostic categories has led to the NIMH Research Domain Criteria (RDoC) project, which is laying the foundation for a new mental disorders classification system based on brain circuits and dimensional mechanisms that cut across traditional diagnostic categories.

The research was also funded by NIH's Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).

I will not get any shot while pregnant or take any medication unless it is desperately needed. They are always saying things are safe during pregnancy but then come out a few years later saying they are not.

I see how not getting the flu during pregnancy is good but I don't see how the flu vaccine actually prevents the flu.

My midwife pointed out that the vaccine is for the 2 most common strains of flu for the previous year. Except it hadn't changed in a year or so, so it was actually for the most common strains of a few years prior.

DH was the only one in our home to get the flu shot when I was pregnant. Guess where he was when I was supposed to be coming home from the hospital -- at home with the flu, the stomach flu, a strain NOT covered by the shot.

I took elderberry syrup daily when pregnant, I didn't want the flu vaccine and don't think that this study would encourage me to get the vaccine, it would only encourage me to work on my immune system in other ways.

I will not get any shot while pregnant or take any medication unless it is desperately needed. They are always saying things are safe during pregnancy but then come out a few years later saying they are not.

This is saying, though, that there is a big risk for having a child with bipolar disorder if you get flu while pregnant.

I don't know how I feel about this, to be honest. I am all for vaccinating, but I know flu shots don't always work, you can get strains they haven't vaccinated you for because it's guesswork as to what the strains will be.

I think if I had a bipolar child and was sick while pregnant and didn't vaccinate myself, though, I would feel guilty.

I see how not getting the flu during pregnancy is good but I don't see how the flu vaccine actually prevents the flu.

My midwife pointed out that the vaccine is for the 2 most common strains of flu for the previous year. Except it hadn't changed in a year or so, so it was actually for the most common strains of a few years prior.

DH was the only one in our home to get the flu shot when I was pregnant. Guess where he was when I was supposed to be coming home from the hospital -- at home with the flu, the stomach flu, a strain NOT covered by the shot.

I took elderberry syrup daily when pregnant, I didn't want the flu vaccine and don't think that this study would encourage me to get the vaccine, it would only encourage me to work on my immune system in other ways.

I understand what it's saying. I'm still not getting the flu shot while pregnant. You could still get the flu anyway.

Quoting romalove:

Quoting norahsmommy:

I will not get any shot while pregnant or take any medication unless it is desperately needed. They are always saying things are safe during pregnancy but then come out a few years later saying they are not.

This is saying, though, that there is a big risk for having a child with bipolar disorder if you get flu while pregnant.

I don't know how I feel about this, to be honest. I am all for vaccinating, but I know flu shots don't always work, you can get strains they haven't vaccinated you for because it's guesswork as to what the strains will be.

I think if I had a bipolar child and was sick while pregnant and didn't vaccinate myself, though, I would feel guilty.

Working as an ER nurse and getting exposed to flu many times a year (especially in triage where people sit right in your face in a non-ventilated room all night, coughing on you. You'd be amazed how few people cover their mouths!!!), my OB (who is not pushy at all about vaccines) and I decided it was better for me to get vaccinated.

We had a number of patients test positive for the strains included in last years vaccine. I am not a huge pro-vax person, but I feel like it was the right choice for me last year, and if I'm pregnant during flu season again I will likely make the same choice if I can get immunized before getting pregnant. I have a very high-risk, front-line type job and we have has maternal/fetal fatalities in the area from influenza. It's no joke.

Working as an ER nurse and getting exposed to flu many times a year (especially in triage where people sit right in your face in a non-ventilated room all night, coughing on you. You'd be amazed how few people cover their mouths!!!), my OB (who is not pushy at all about vaccines) and I decided it was better for me to get vaccinated.

We had a number of patients test positive for the strains included in last years vaccine. I am not a huge pro-vax person, but I feel like it was the right choice for me last year, and if I'm pregnant during flu season again I will likely make the same choice if I can get immunized before getting pregnant. I have a very high-risk, front-line type job and we have has maternal/fetal fatalities in the area from influenza. It's no joke.

Thanks for your input.

Do you think the specter of a potential mental illness would make people think twice about vaccinating who otherwise wouldn't bother?

I agree for the same reason. If I wasn't a nurse at risk with so much exposure, I wouldn't do it. Thankfully, I never had to worry about it. I get the flu shot every year though and not just because it is mandated.

Quoting unspecified42:

Working as an ER nurse and getting exposed to flu many times a year (especially in triage where people sit right in your face in a non-ventilated room all night, coughing on you. You'd be amazed how few people cover their mouths!!!), my OB (who is not pushy at all about vaccines) and I decided it was better for me to get vaccinated.

We had a number of patients test positive for the strains included in last years vaccine. I am not a huge pro-vax person, but I feel like it was the right choice for me last year, and if I'm pregnant during flu season again I will likely make the same choice if I can get immunized before getting pregnant. I have a very high-risk, front-line type job and we have has maternal/fetal fatalities in the area from influenza. It's no joke.

Which is exactly what I was saying. Guesswork during pregnancy doesn't suit me.

Quoting romalove:

Quoting anxiousschk:

I see how not getting the flu during pregnancy is good but I don't see how the flu vaccine actually prevents the flu.

My midwife pointed out that the vaccine is for the 2 most common strains of flu for the previous year. Except it hadn't changed in a year or so, so it was actually for the most common strains of a few years prior.

DH was the only one in our home to get the flu shot when I was pregnant. Guess where he was when I was supposed to be coming home from the hospital -- at home with the flu, the stomach flu, a strain NOT covered by the shot.

I took elderberry syrup daily when pregnant, I didn't want the flu vaccine and don't think that this study would encourage me to get the vaccine, it would only encourage me to work on my immune system in other ways.

Working as an ER nurse and getting exposed to flu many times a year (especially in triage where people sit right in your face in a non-ventilated room all night, coughing on you. You'd be amazed how few people cover their mouths!!!), my OB (who is not pushy at all about vaccines) and I decided it was better for me to get vaccinated.

We had a number of patients test positive for the strains included in last years vaccine. I am not a huge pro-vax person, but I feel like it was the right choice for me last year, and if I'm pregnant during flu season again I will likely make the same choice if I can get immunized before getting pregnant. I have a very high-risk, front-line type job and we have has maternal/fetal fatalities in the area from influenza. It's no joke.

Send me email updates about messages I've received on the site and the latest news from The CafeMom Team.
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